RESUMEN
Extranodal natural killer/T cell lymphoma, nasal type, is a non-Hodgkin lymphoma, most commonly affecting the nasal cavity, paranasal sinuses and nasopharynx. Clinically it is characterised by destruction of facial tissues, commencing in the midline. In most cases it arises from malignant transformation of natural killer cells (NK); sometimes from malignant transformation of cytotoxic T cells.Extranodal NK/T cell lymphoma, nasal type, is rare, but even more rare in black persons. The purpose of this article is to report a severe case of extranodal NK/T cell lymphoma, nasal type, in an elderly black male.
Asunto(s)
Granuloma Letal de la Línea Media/diagnóstico , Linfoma Extranodal de Células NK-T/diagnóstico , Anciano , Población Negra , Antígeno CD56/metabolismo , Resultado Fatal , Granuloma Letal de la Línea Media/diagnóstico por imagen , Granuloma Letal de la Línea Media/etnología , Granuloma Letal de la Línea Media/metabolismo , Granuloma Letal de la Línea Media/patología , Humanos , Inmunohistoquímica , Linfocitos/patología , Linfoma Extranodal de Células NK-T/diagnóstico por imagen , Linfoma Extranodal de Células NK-T/etnología , Linfoma Extranodal de Células NK-T/metabolismo , Linfoma Extranodal de Células NK-T/patología , Masculino , Invasividad Neoplásica , Tomografía Computarizada por Rayos XRESUMEN
To investigate the expression of survivin gene and its relationship with Epstin-Barr virus (EBV) infection in midline T-cell lymphoma (MTL), immunohistochemistry staining method was used to examine the expression of survivin and EBV-latent membrane protein (LMP-1) in the 41 cases. In situ hybridization (ISH) was used to detect EBV-encoded RNA (EBER1/2). The results showed that the expression of survivin was positive in 26 cases of midline T-cell lymphoma, but no positive was detected in 10 cases of reactive lymphoid tissues. The positive expression ratio of survivin was 12.5% in cases of MTL with low grade of malignancy, and was 75.76% in cases of MTL with middle and high grades of malignancy, the significant difference was found between these two groups (chi(2) = 8.55, P < 0.01). Positive expression ratios of EBER1/2 and LMP-1 were 70.73% and 41.46% respectively. Survivin expression was not significantly different between EBER1/2 positive and negative cases (P > 0.05). It is concluded that survivin expression is up-regulated in MTL, and survivin positive expression rate is associated with the degree of malignancy. Survivin may play a role in the pathogenesis of the MTL by influencing cell apoptosis. EBV infection is not significantly associated with survivin expression in the MTL.
Asunto(s)
Infecciones por Virus de Epstein-Barr/patología , Granuloma Letal de la Línea Media/patología , Linfoma de Células T/patología , Proteínas Asociadas a Microtúbulos/biosíntesis , Proteínas de Neoplasias/biosíntesis , Neoplasias Nasales/patología , Proteínas Adaptadoras Transductoras de Señales , Adolescente , Adulto , Anciano , Niño , Proteínas del Citoesqueleto , Infecciones por Virus de Epstein-Barr/metabolismo , Infecciones por Virus de Epstein-Barr/virología , Femenino , Granuloma Letal de la Línea Media/metabolismo , Granuloma Letal de la Línea Media/virología , Humanos , Inmunohistoquímica , Hibridación in Situ , Proteínas Inhibidoras de la Apoptosis , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Proteínas con Dominio LIM , Linfoma de Células T/metabolismo , Linfoma de Células T/virología , Masculino , Persona de Mediana Edad , Neoplasias Nasales/metabolismo , Neoplasias Nasales/virología , ARN Viral/genética , SurvivinAsunto(s)
Granuloma Letal de la Línea Media/diagnóstico , Células Asesinas Naturales/patología , Linfoma de Células T/diagnóstico , Neoplasias de los Senos Paranasales/diagnóstico , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores de Tumor/análisis , Ciclofosfamida/uso terapéutico , Cartilla de ADN/química , ADN de Neoplasias/análisis , Diagnóstico Diferencial , Doxorrubicina/uso terapéutico , Granuloma Letal de la Línea Media/tratamiento farmacológico , Granuloma Letal de la Línea Media/metabolismo , Humanos , Células Asesinas Naturales/química , Células Asesinas Naturales/efectos de los fármacos , Linfoma de Células T/química , Linfoma de Células T/tratamiento farmacológico , Masculino , Neoplasias de los Senos Paranasales/química , Neoplasias de los Senos Paranasales/tratamiento farmacológico , Reacción en Cadena de la Polimerasa , Prednisona/uso terapéutico , Vincristina/uso terapéuticoRESUMEN
We had 18 patients (15 males and 3 females) with lethal midline granuloma (polymorphic reticulosis) in the period from 1981 to 1990. This number was about 5.6% of the total number of patients with malignant head and neck tumors that we encountered during this period. An average of 9.1 months separated the first appearance of disease and the beginning of treatment. Most of the 18 patients underwent both radiation therapy and chemotherapy (COP, CHOP, MACOP-B), but, since their disease had reached an advanced stage, 3 underwent radiation therapy only, 3 underwent chemotherapy only, and 1 received no radical therapy at all. Of the 18 patients, 13 died of the disease. In of 6 of these, the disease was confined to the local lesion. The 5-year cumulative survival rate was 15.7% (Kaplan-Meier). Fourteen autopsy studies revealed that tumor cells had invaded the liver (92.8%), lung (92.8%) and spleen (71.4%) and in all cases it was in leukemic patterns. Fifteen cases were studied for tumor surface marker phenotype, but none was found to be positive for L26, CD43, Leu M1 (CD15), or MAC 387. Five cases were positive for UCHL-1 (CD45RO) and 10 cases were positive for lysozyme. All cases were positive for Ki-1 (CD30).
Asunto(s)
Granuloma Letal de la Línea Media/terapia , Adulto , Anciano , Biomarcadores de Tumor/metabolismo , Femenino , Granuloma Letal de la Línea Media/metabolismo , Humanos , Inmunohistoquímica , Enfermedades Linfáticas/metabolismo , Enfermedades Linfáticas/terapia , Masculino , Persona de Mediana Edad , Neoplasias Nasales/metabolismo , Neoplasias Nasales/terapia , PronósticoRESUMEN
The present report describes the results of a combined morphological, enzyme- and immunohistochemical analysis of nine cases of malignant non Hodgkin's lymphomas (NHL) clinically presenting as lethal midline granuloma. In a previous report written before antibodies directed against B and T lymphocytes were available, a histiocytic origin of such neoplasms had been suggested. A panel of antibodies reactive with most B cells (L26, MB1, KiB3) and a majority of T cells (MT1, UCHL1) was applied on paraffin sections of formalin fixed tissues as well as antibodies directed against leukocyte common antigen (LCA), myeloid/histiocyte antigen (MAC 387), lysozyme, alpha-1-antitrypsin, alpha-1-antichymotrypsin, S-100 protein, prekeratin and immunoglobulin light chains. Enzyme histochemistry included tests for non-specific acid esterase, acid phosphatase, beta-glucuronidase and chloroacetate esterase. As a result, five T, two B and two unclassified (malignant histiocytosis probable) NHL were identified, indicating distinct heterogeneity of NHL as causative disorders in lethal midline granuloma.
Asunto(s)
Granuloma Letal de la Línea Media/etiología , Linfoma no Hodgkin/complicaciones , Adolescente , Adulto , Anciano , Antígenos de Diferenciación/metabolismo , Linfocitos B/inmunología , Femenino , Granuloma Letal de la Línea Media/metabolismo , Granuloma Letal de la Línea Media/patología , Antígenos de Histocompatibilidad/metabolismo , Humanos , Inmunohistoquímica , Antígenos Comunes de Leucocito , Linfoma no Hodgkin/metabolismo , Linfoma no Hodgkin/patología , Macrófagos/inmunología , Masculino , Persona de Mediana Edad , Proteínas S100/metabolismo , alfa 1-Antiquimotripsina/metabolismo , alfa 1-Antitripsina/metabolismoRESUMEN
The immunoreactivity of the trophic peptide insulin-like growth factor I (IGF-I; somatomedin C) was mapped in nasal mucosa biopsies from three patients with Wegener's granulomatosis (WG) and one with idiopathic midline destructive disease (IMDD; idiopathic midline granuloma). Strongly increased IGF-I immuno-reactivity restricted to cells bordering and in vessel walls and in granulomas (WG) was demonstrated, while necrotic and noninflammatory areas were negative. Treatment with steroids and cyclophosphamide reduced the IGF-I immunoreactivity. The abnormally increased IGF-I immunoreactivities in WG and IMDD probably reflects the reactive growth processes in diseased tissue and is not thought to be the primary cause of either disease. IGF-I may be formed locally by cells in and close to the vascular walls in areas with active disease resulting in e.g. vascular growth, granuloma formation, and finally vessel obliteration and necrosis. IGF-I is likely to form, possibly in concert with other trophic factors, a link in the chain of events resulting in the tissue abnormalities in WG and IMDD.